Suggest Treatment For Enlarged Uterus With Menstrual Cramps

During a routine exam when I was 34 (I'm now 46) my doctor was wondering why my uterus felt so enlarged ( I had the exam because my periods were coming closer together )I had no pain or anything (used to have menstrual cramps but this resolved on it's own (for the most part) in my mid twenties. Doctor said it could possibly be fibroids but didn't push me to have further testing (although left a sonogram totally up to me) Is an enlarged uterus ALWAYS something to be concerned about?